Sertraline
An SSRI used for depression, OCD, PTSD, panic disorder and social anxiety disorder.
Drug card
- Class
- SSRI
- How it works
- Blocking serotonin reuptake, so serotonin stays longer in the synapse
- Used for
- Depression
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Known for
- Diarrhea or loose stools
- Ejaculation failure and low libido
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does sertraline work?
Sertraline strongly and selectively blocks serotonin reuptake; its action on norepinephrine and dopamine uptake is very weak, and it barely binds adrenergic, muscarinic or histamine receptors. It inhibits CYP2D6, so drugs cleared by that enzyme may need lower doses.
Like other selective serotonin reuptake inhibitors: SSRIs block the serotonin transporter (SERT) on presynaptic nerve endings, so released serotonin is cleared more slowly and acts longer on its receptors. The block is immediate but mood lifts only after weeks, so slower receptor adaptations are thought to matter; the exact mechanism is unknown. Unlike tricyclics, they barely affect norepinephrine reuptake or muscarinic, histamine and α1 receptors.
Uses
What is sertraline used for?
- Depression
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
Side effects
Side effects of sertraline
- Diarrhea or loose stoolsKnown for
- Ejaculation failure and low libidoKnown for
- Nausea
- Tremor
- Indigestion
- Heavy sweating
- Trouble sleeping or drowsiness
- Serotonin syndromeSerious
- Suicidal thoughts in children and young adultsSerious
- Low sodium (hyponatremia)Serious
- Abnormal bleedingSerious
- Mania in people with bipolar disorderSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Contraindicated with MAOIs (leave 14 days either way) and with pimozide.
- Lower the dose of CYP2D6-cleared drugs, and watch warfarin and other highly protein-bound drugs.
- Use with care in people with QT risk factors or a seizure disorder.
Good to know: Its US license covers PTSD and social anxiety disorder as well as depression, OCD and panic disorder, and it is used for OCD in children from age 6.
Remember it
A way to remember it
SSRI
- S
- Sexual problems
- S
- Serotonin syndrome
- R
- Reduced sodium (hyponatremia)
- I
- Increased bleeding risk
Written for biofideX
Its class
Selective serotonin reuptake inhibitors
Other selective serotonin reuptake inhibitors with a card:
Easily mixed up with serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Depression, anxiety and sleep
Sertraline is one of 15 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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